This notice is intended to describe how Health Information may be used and/or disclosed and how You can access your Identifiable Health Information. Please review this notice carefully. If you have any questions regarding this notice, please contact us at 4004 Junction Blvd. Corona, NY 11368

Understanding your health record/information:

Each time you visit a hospital, physician, or each time a healthcare professional visits your home a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnosis, treatment and a plan for future care or treatment. This information often referred to as your health or medical record, serves as a basis for planning your care and treatment and serves as a means of communication among the many health professionals who contribute to your care. Understanding what is in your record and how your health information is used helps you to ensure its accuracy, better understand who, what, when, where and why others may access your health information, and make more informed decisions when authorizing disclosure to others.

Your health information rights:

Unless otherwise required by law your health record is the physical property of the healthcare practitioner or facility that compiled it, but the information belongs to you. You have the right to: Request in writing a restriction on certain uses and disclosures of your information. The Agency is not required to agree to comply with your requested restriction. Request in writing amendments to your health record, either clinical or demographic. Inspect and request in writing a copy of your health record. Obtain an accounting of disclosures of your health information. Request communications of your health information by alternative means or at alternative locations. Revoke your authorization to use/disclose health information except to the extent that action has already been taken.

Our responsibilities:

The Agency is required to maintain the privacy of your health information. In addition, we will:

Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you and will abide by the terms of this notice Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

For more information or to report a problem:

If you have questions and would like additional information, you may contact the chief compliance officer anonymously within NYC, Nassau and Suffolk County at 844-713-0004. If you believe your privacy rights have been violated, you can also file a complaint with the NYS Department of Health at 212-417-5888. There will be no retaliation for filing a complaint.

We will use your health information for treatment:

Information obtained by the assessment professional will be recorded in your record and used to determine the course of treatment that should work best for you. By way of example, members of your healthcare team will then record the actions they took, their observations and education provided. We will also provide other practitioners involved with your care with copies of various reports that should assist them in treating you as well as enabling your physician to

provide orders for your homecare.

We will use your health information for payment:

Your information will be utilized to obtain payment for services provided. A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, services provided, and supplies used. Outside collection agencies may also be utilized.

Business Associates:

There may be some services provided in our organization through contracts with Business Associates. Examples may include therapy services, laboratory tests, supplies, and audit services. When these services are contracted, we may disclose some or all your health information to our Business Associate so they can perform the business we’ve asked them to do. To protect your health information, we require the Business Associate to safeguard your information.

We will use your health information for regular healthcare operations:

We may use and disclose health information in order to facilitate operations and to provide quality care to all patients.

Examples include: Quality assessment and improvement activities. Activities designed to improve health or reduce healthcare costs. Protocol development, case management and care coordination. Employee performance and evaluation. Training programs including those in which students, trainees or practitioners in healthcare learn under supervision. Accreditation, certification, licensing or credentialing activities. Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs. Business planning and development. Patient satisfaction surveys. In coordination of emergency and disaster planning and implementation.

Communication with family:

Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friends or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.


We may disclose information to researchers when a review board that has reviewed the research proposal, and established protocols to ensure the privacy of your health information has approved their research.


We may contact you to provide information about your treatment alternatives or other health related benefits and services that may be of interest to you.

Food and Drug Administration (FDA):

As required by law we may disclose to the FDA health information relative to adverse events with respect to food, supplements, products/product defects or marketing surveillance information to enable product recalls, repairs or replacement.

Workers compensation:

We may disclose health information to the extent authorized by state or other laws and to the degree necessary to comply with those laws relating to workers compensation or other similar laws.

Public health:

As required by law, we may disclose your health information to public health or legal authorities charged with tracking birth and deaths, as well as preventing or controlling disease, injury or disability.

Law enforcement:

We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Federal law makes provisions for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

Notice of Privacy Practices availability:

This notice will be prominently posted in the office. Patient will be provided a hard copy.

Authorization to use or disclose health information:

Other than stated in this document, the Agency will not disclose your health information without your written authorization. If you or your representative authorizes the Agency to use or disclose your health information, you may revoke such authorization in writing at any time. Any further questions or concerns may be directed to the Agency’s CCO at 844-713-0004.